Acute Abdomen Secondary to a Spontaneous Perforation of the Biliary Tract, a Rare Complication of Choledocholithiasis.
Acute Abdomen Secondary to a Spontaneous Perforation of the Biliary Tract, a Rare Complication of Choledocholithiasis.
复制标题
继发于胆道自发性穿孔的急性腹部，是胆总管结石的罕见并发症。
DOI：
10.1016/j.ijscr.2017.10.040
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发表时间：
2017
影响因子：
0.6
通讯作者：
Ploneda-Valencia,CF
中科院分区：
文献类型：
--
作者：
Gómez-Torres,GA;Rodríguez-Navarro,FM;López-Lizárraga,CR;Bautista-López,CA;Ortega-García,OS;Becerra-Navarro,G;Águila-Barragán,A;Ploneda-Valencia,CF
自发性胆道穿孔（spontaneous perforation of the biliary tract，SPBT）是一种极为罕见的腹膜炎，由弗里兰于1982年首次报道，迄今为止仅报道了约70例。在这里，我们提出了一个自发性的胆道穿孔的情况下，在胆总管结石的患者，这是治疗与超声引导下引流和ERCP。Case reportA 51岁的男性被收进急诊室的15天演变黄疸，局部疼痛的右侧腹和腹下3天。他15年前有胆囊切除术史，4次胆管炎发作，最后一次发生在2015年。进行了磁共振成像（MRI），除可能的胆漏外，还显示胆总管结石的证据。患者经超声引导下引流和ERCP成功治疗。DiscussionSpontaneous perforation of the biliary tract is a disease entity in which wall of extrahepatic or intrahepatic duct is perforated without any traumatic or医源性损伤。临床表现从非特异性腹痛到胆汁性腹膜炎不等，大多数病例形成胆汁瘤。普遍的管理涉及减压的胆道树和修复泄漏situ.ConclusionThe自发性穿孔的胆道是一种疾病，代表了诊断的挑战。SPBT患者的治疗尚未得到很好的确立，必须根据患者的病史、穿孔部位、演变时间、疑似感染和患者状态对每个病例进行个性化治疗。
IntroductionThe spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP.Case reportA 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3 days. He had a history of cholecystectomy 15 years ago and 4 episodes of cholangitis, the last one in 2015. A magnetic resonance imaging (MRI) was performed, that showed evidence of choledocholithiasis, in addition to a possible biliary leakage. The patient was treated with ultrasound-guided drainage and ERCP successfully.DiscussionSpontaneous perforation of the biliary tract is a disease entity in which wall of the extrahepatic or intrahepatic duct is perforated without any traumatic or iatrogenic injury. The clinical presentation varies from nonspecific abdominal pain to biliary peritonitis, in most of the cases forming bilomas. Universal management involves decompression of the biliary tree and repair of the leak site.ConclusionThe spontaneous perforation of the biliary tract is a disease that represents a diagnostic challenge. The treatment in the patients with SPBT is not well established and has to be individualized for each case, depending on the history of the patient, the site of perforation, the time of evolution, the suspicion of infection, and the patient status.